Author + information
- Larisa G. Tereshchenko,
- Jason Thomas,
- Allison Junell and
- Charles Henrikson
Background: Patients’ awareness of cardiovascular disease (CVD) improves survival. Deep terminal negativity of P-prime in V1 (DTNPV1) is associated with CVD mortality in the general population. We hypothesized that DTNPV1 and CVD awareness is associated with all-cause mortality in a large tertiary healthcare system patient population.
Methods: Retrospective double cohort study compared two levels of exposure (automatically measured amplitude of P-prime (Pp) in V1): DTNPV1 (Pp from −100μV to −200μV) and ZeroPpV1 (Pp=0). An entire healthcare system ECG database was screened. Medical records of children and patients with previously diagnosed atrial fibrillation, implanted pacemaker or cardioverter-defibrillator were excluded. DTNPV1 (n=3,413) and ZeroPpV1 (n=3,405) cohorts were matched by age and sex. All-cause mortality served as the primary outcome. Median follow-up was 2.5 y.
Results: DTNPV1 was associated with all-cause mortality (Cox regression HR 1.95(1.64-2.31); P<0.0001) after adjustment for CVD, comorbidities, ECG risk markers, medications, and index ECG referral. Index ECG referral by a cardiologist was independently associated with reduction of mortality (HR 0.66(0.52-0.84); P=0.001) (Figure).
Conclusions: DTNPV1 is independently associated with twice higher risk of all-cause death, as compared to patients without P prime in V1. ECG screening for DTNPV1 with subsequent referral to a cardiologist should be tested in a randomized clinical trial.
Poster Hall, Hall C
Friday, March 17, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Current Issues in Cardiovascular Epidemiology, Disparities, and Safety
Abstract Category: 32. Prevention: Clinical
Presentation Number: 1148-047
- 2017 American College of Cardiology Foundation